Difference between revisions of "Small Animal Emergency and Critical Care Medicine Q&A 09"
(4 intermediate revisions by 2 users not shown) | |||
Line 1: | Line 1: | ||
− | + | <br /> | |
− | |||
− | |||
− | <br> | ||
− | |||
− | + | '''A two-year-old mixed-breed bitch had four puppies 16 days ago. The puppies seem healthy but the owners report that the dam is salivating, walking stiffly, panting and has muscle tremors.''' | |
− | ''' | ||
<br /> | <br /> | ||
− | <FlashCard questions=" | + | <FlashCard questions="4"> |
− | |q1=What | + | |q1=What is your tentative diagnosis? |
− | |||
− | |||
− | |||
− | |||
|a1= | |a1= | ||
− | + | Eclampsia. | |
− | + | |l1=Hypocalcaemia#Eclampsia | |
− | + | |q2=What potential problems in the dam should be ruled out with your initial data base and physical examination? | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |l1= | ||
− | |q2=What | ||
|a2= | |a2= | ||
− | + | Hypocalcemia is often accompanied by hyperthermia, dehydration, hypoglycemia and cardiac arrhythmias. | |
− | |l2= | + | |l2=Hypocalcaemia#Eclampsia |
− | |q3=What | + | |q3=What is your management plan for this case? |
|a3= | |a3= | ||
− | + | Ten percent calcium gluconate (0.5–1.5 ml/kg) should be administered slowly i/v until clinical signs regress. The drug must be discontinued if bradycardia or other arrhythmias are noted on ECG. Vomition or ‘licking the lips’ are indications that i/v administration should be discontinued. | |
− | + | ||
− | + | A second dose of calcium gluconate (1–2 ml/kg) can be given s/c if it is diluted 50:50 with saline. | |
− | + | ||
− | + | Fever, dehydration and hypoglycemia can be managed with i/v fluid therapy. | |
− | |l3= | + | |
+ | Ideally, the pups should be removed and hand raised, but if they are allowed to remain with the dam, she should receive oral calcium supplementation (25–50 mg/kg/day divided every 8 hours) until lactation is completed. | ||
+ | |l3=Hypocalcaemia#Eclampsia | ||
+ | |q4=What problems have been associated with oral and parenteral calcium administration? | ||
+ | |a4= | ||
+ | Calcium supplementation prior to whelping inhibits parathormone secretion and makes the dam more prone to hypocalcemia during lactation. | ||
+ | |||
+ | If i/v calcium is administered too rapidly, cardiac arrhythmias may result. Oversupplementation with calcium may cause arrhythmias, neurologic impairment, GI dysfunction and renal failure. | ||
+ | |||
+ | Calcium chloride must never be administered i/m or s/c, as tissue necrosis and skin sloughs can occur. | ||
+ | |l4=Hypocalcaemia#Eclampsia | ||
</FlashCard> | </FlashCard> | ||
Line 47: | Line 37: | ||
rect 0 0 860 850 [[Small Animal Emergency and Critical Care Medicine Q&A 10|Small Animal Emergency and Critical Care Medicine Q&A 10]] | rect 0 0 860 850 [[Small Animal Emergency and Critical Care Medicine Q&A 10|Small Animal Emergency and Critical Care Medicine Q&A 10]] | ||
desc none}} | desc none}} | ||
− | |||
[[Category:Small Animal Emergency and Critical Care Medicine Q&A]] | [[Category:Small Animal Emergency and Critical Care Medicine Q&A]] |
Revision as of 16:22, 18 August 2011
A two-year-old mixed-breed bitch had four puppies 16 days ago. The puppies seem healthy but the owners report that the dam is salivating, walking stiffly, panting and has muscle tremors.
Question | Answer | Article | |
What is your tentative diagnosis? | Eclampsia. |
Link to Article | |
What potential problems in the dam should be ruled out with your initial data base and physical examination? | Hypocalcemia is often accompanied by hyperthermia, dehydration, hypoglycemia and cardiac arrhythmias. |
Link to Article | |
What is your management plan for this case? | Ten percent calcium gluconate (0.5–1.5 ml/kg) should be administered slowly i/v until clinical signs regress. The drug must be discontinued if bradycardia or other arrhythmias are noted on ECG. Vomition or ‘licking the lips’ are indications that i/v administration should be discontinued. A second dose of calcium gluconate (1–2 ml/kg) can be given s/c if it is diluted 50:50 with saline. Fever, dehydration and hypoglycemia can be managed with i/v fluid therapy. Ideally, the pups should be removed and hand raised, but if they are allowed to remain with the dam, she should receive oral calcium supplementation (25–50 mg/kg/day divided every 8 hours) until lactation is completed. |
Link to Article | |
What problems have been associated with oral and parenteral calcium administration? | Calcium supplementation prior to whelping inhibits parathormone secretion and makes the dam more prone to hypocalcemia during lactation. If i/v calcium is administered too rapidly, cardiac arrhythmias may result. Oversupplementation with calcium may cause arrhythmias, neurologic impairment, GI dysfunction and renal failure. Calcium chloride must never be administered i/m or s/c, as tissue necrosis and skin sloughs can occur. |
Link to Article |